Efekat hidroksiapatita i faktora rasta na stvaranje reparativnog dentina u terapiji ledirane pulpe
Sažetak
Uvod/Cilj. Studije o hidroksiapatitu (HAp) i faktorima rasta kao materijalima za direktno prekrivanje pulpe daju potpuno oprečne rezultate i po pitanju zapaljenskog odgovora i po pitanju formiranja kalcifikovanog mosta. Kalcijum hidroksiapatit/poli (laktid-ko-glikolid) je bioresorbilni polimer koji je pokazao dobra svojstva kao nosač koštanog morfogenog proteina neophodnog za regeneraciju koštanog tkiva. Uloga faktora rasta u reparaciji zubnih tkiva (bilo da se radi o reaktivnoj ili reparativnoj dentinogenezi) daje nove osnove i drugačiji pristup tretmanu pulpe. Faktori rasta – transformišući faktor rasta beta-1 (ТGF β-1) direktno indukuju morfološku i funkcionalnu diferencijaciju neoodontoblasta. Cilj ove eksperimentalne studije bio je da se ispitа uticaj kalcijum HAp/poli (laktid-ko-glikolida) (HAp/PLGA) i faktora rasta ТGF β-1 u stvaranju kalcifikovanog tkiva – dentinskog mosta na zubima eksperimentalnog modela. Metode. U eksperimentalnoj studiji kao animalni model korišćeni su zubi glodara (kunića). Nakon trepanacije pulpnog prostora sterilnim čeličnim svrdlom, pulpa je prekrivena kalcijum HAp/PLGA (I eksperimentalna grupa zuba, n = 60), kalcijum HAp/PLGA u kombinaciji sa faktorom rasta TGF β-1 (II eksperimentalna grupa, n = 60),
kontrolna grupa zuba (intaktni zubi, n = 20). Eksperiment je obavljen u opštoj anesteziji. Životinje su održavane u životu 1, 3 i 6 meseci. Ekstrahovani zubi su pripremljeni za posmatranje skenirajućom elektronskom mikroskopijom. Rezultati. Skenirajućom elektronskom mikroskopijom dokazano je da je broj zuba sa kalcifikovanim tkivom u vidu dentinskog mosta bio veći 6 meseci nakon tretmana u odnosu na 3 meseca nakon tretmana. Zaključak. Direktnim prekrivanjem pulpe dolazi do zatvaranja artificijelno otvorene pulpe i stvaranja dentinskog mosta reparatornog dentina tubularne strukture u toku perioda posmatranja od 3 meseca.
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